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Aids to Daily Living

Problem: Maintaining or improving residents’ daily living is important to attracting and retaining nursing home residents. It also is one of ten quality measures (QMs) in the Centers for Medicaid & Medicare Services (CMS) Five-Star Rating. Your facility’s quality performance in ADLs is evaluated based on three CMS regulations:

F310 A resident’s abilities in activities of daily living do not diminish unless circumstances of the individual’s clinical condition demonstrate that diminution was unavoidable. This includes the resident’s ability to: (i) Bathe, dress, and groom; (ii) Transfer and ambulate; (iii) Toilet; (iv) Eat; and (v) Use speech, language, or other functional communication systems.
Intent §483.25(a): The intent of this regulation is that the facility must ensure that aresident’s abilities in ADLs do not deteriorate unless the deterioration was unavoidable.

F311 A resident is given the appropriate treatment and services to maintain or improve his or her abilities specified in paragraph (a)(1)* of this section; and interpretive guidelines
Intent §483.25(a)(2): The intent of this regulation is to stress that the facility is responsible for providing maintenance and restorative programs that will not only maintain, but improve, as indicated by the resident’s comprehensive assessment to achieve and maintain the highest practicable outcome.

F312 A resident who is unable to carry out activities of daily living receives the necessaryservices to maintain good nutrition, grooming, and personal and oral hygiene.
Intent §483.25(a)(3): The intent of this regulation is that the resident receives the care and services needed because he/she is unable to do their own ADL care independently.

Solution: To help you improve your nursing home’s ADL quality outcomes—and its CMS Five-Star quality rating—Briggs has assembled the specific documentation, charting, education and training, and medical supplies you’ll need. Remember, every Briggs form integrates industry best practices, and has been recognized by customers as best-of-class.

Download the Quality Improvement Measure Guide for Aids to Daily Living [PDF].

Documentation
		Pack	List Price
Assessments
CFS6-1HH	ADL Functional/Restorative Assessment and Progress	100/pad	12.28
CFS6-1HF	ADL Functional/Restorative Assessment and Progress	100/pad	12.28
CFS6-12HH	Range of Motion Assessment	100/pad	12.28
CFS6-12HF	Range of Motion Assessment	100/pad	12.28
Rehabilitation & Therapy
CFS10-1HH	Rehabilitation Screen	100/pad	12.28
CFS10-1HF	Rehabilitation Screen	100/pad	12.28
3789HH	Rehabilitation Evaluation	100/pk	28.72
3790HH	Rehabilitation Treatment Plan	100/pad	12.28
3628	Resident Functional Assessment	100/pad	9.54
CFS6-12HH	Range of Motion Assessment	100/pad	12.28
CFS6-12HF	Range of Motion Assessment	100/pad	12.28
3626	Rehabilitation Nursing Program Evaluation	100/pad	9.54
CFS10-6HH	Therapy Treatment Progress Notes	100/pad	12.28
CFS10-6HF	Therapy Treatment Progress Notes	100/pad	12.28
CFS10-5/4P	Therapy Progress Notes	100/pk	43.45
1045	Therapy Notes	100/pad	11.67
3794P	Occupational Therapy Daily Service and Treatment Grid	100/pk	46.65
CFS10-3HH	Occupational Therapy Evaluation and Treatment Plan	100/pad	12.28
3793P	Occupational Therapy Progress Status	100/pad	10.2
1009B	Physical Therapy Progress Record	100/pad	11.67
1008	14-Month Physical Therapy Record	100/pad	11.67
1433/2	Physical Therapy Requisition and Charge	100/pk	31.95
3791P	Physical Therapy Progress Status	100/pad	10.20
3792P	Physical Therapy Daily Service and Treatment Grid	100/pk	46.95
CFS10-2HH	Physical Therapy Evaluation and Treatment Plan	100/pad	12.28
3424P	Tinetti Assessment tool:Balance and Gait	100/pad	10.20
Restorative Nursing
3715HH	Restorative Nursing Program Needs Identification	100/pad	12.28
3721HH	Functional Restorative Progress Comparison	100/pad	12.28
3722HH	Functional Restorative Progress Comparison Addendum	100/pad	12.28
3726	Restorative Program Tracking Form	100/pk	28.95
3720HH	Restorative Nursing Care Plan and Progress Notes	100/pad	12.28
3727	CAN Care Plan Reference Sheet	100/pad	12.28
3632HH	Restorative Care Flow Record SC	100/pad	12.28
3732	Restorative Meeting Summary	100/pad	10.20
3241	Restorative Aide Notes	100/pad	11.67
3717HH	Restorative Nursing Transfer Form	100/pad	12.28
3718HH	Restorative Nurse's Progress Notes	100/pad	12.28
3740P	Restorative Nurse's Progress Notes	100/pad	10.20
CFS6-33HH	Rehabiltiaion/Restorative Service Delivery Record	100/pad	12.28
CFS6-33HF	Rehabiltiaion/Restorative Service Delivery Record	100/pad	12.28
3731HH	5-Week Restorative care Flow Record	100/pad	12.28
3731HF	5-Week Restorative care Flow Record	100/pad	12.28
3719HH	1-month Restorative Care Flow Record	100/pad	12.28
3719HF	1-month Restorative Care Flow Record	100/pad	12.28
CFS6-13HH	Restorative Care Flow Record	100/pad	12.28
CFS6-13HF	Restorative Care Flow Record	100/pad	12.28
3145	Late Loss ADL Flow Sheet	100/pad	12.28
Education and Training
8315	F315 Simplified	1 each	79.95
7320	Restorative Simplified	1 each	119.95
7168DV	Techniques in Toileting/Incontinence Care	1 each	149.00

Charting
5583	Chart Divider - ADL Tracking - Poly - Lavender - Side	each	1.35
5583	Chart Divider - ADL Tracking - Poly - Lavender - Bottom	each	1.35
508-G	Chart Divider - Nurse Assistant - Paper - Orange - Side	25/pk	28.75
507-G	Chart Divider - Nurse Assistant - Paper - Orange - Bottom	25/pk	11.50
674	Chart Divider - Restorative - Paper - Orange - Side	25/pk	11.50
675	Chart Divider - Restorative - Paper - Orange - Bottom	25/pk	11.50
676	Chart Divider - Restorative - Tyvek - Orange - Side	25/pk	28.75
677	Chart Divider - Restorative - Tyvek - Orange - Bottom	25/pk	28.75
5689	Chart Divider - Restorative - Poly - Orange - Side	each	1.35
5690	Chart Divider - Restorative - Poly - Orange - Bottom	each	1.35
Medical Supplies
Gait Belts
D 12134	Heelbo® Johnny Grait Belt™	12/bx	163.59
D 12131	Heelbo® Grait Gait Belt, 63"	12/bx	111.8
D 12129	Heelbo® Chair Belt	6/bx	63.04
Mobility	Wheelchairs
503-0658-0200	DMI® 18" Wheelchair with Fixed Armrests	1 each	151.89
503-0664-0200	DMI® 18" Wheelchair with Removable Desk Arms	1 each	165.89
	Transport Chairs
501-1037-0678	DMI® 19" Folding Steel Transport Chair with Hand Brakes, Chrome Frame, Black Seat	1 each	123.09
501-1037-0778	DMI® 19" Folding Steel Transport Chair with Hand Brakes, Burgundy Frame, Black Seat	1 each	123.09
501-1052-2100	DMI® 19" Ultra Lightweight Aluminum Transport Chair, Royal Blue Frame, Black Seat	1 each	133.79
501-1052-4100	DMI® 19" Ultra Lightweight Aluminum Transport Chair, Titanium Frame, Black Seat	1 each	133.79
	Walkers
802-1017-0645	DMI® Single Release Aluminum Folding Walker with 5" Non-Swivel Wheels, Silver	1 each	37.29
802-1079-0600	DMI® Bariatric Two-Button Release Aluminum Folding Walker with Rubber Tips, Silver	1 each	53.39
	Rollators
802-1011-0700	DMI® Aluminum Rollator with Weight-Activated Brakes, Burgundy	1 each	84.29
501-1028-0700	DMI® Lightweight Aluminum Rollator, Burgundy	1 each	105.89
501-1028-2100	DMI® Lightweight Aluminum Rollator, Royal Blue	1 each	105.89
501-1028-4100	DMI® Lightweight Aluminum Rollator, Titanium	1 each	105.89
	Canes
502-1309-0255	DMI® Adjustable Aluminum Cane, Standard Handle, Black	1 each	8.79
802-1333-0200	DMI® Adjustable Quad Cane, Small base, Black	1 each	13.59
ADL's	Eating
D 93-112	CARRYCUP 12 OZ BLUE WHITE LID	1 each	4.19
641-4640-0102	DMI® Comfort Grip™ Cutlery, Teaspoon	1 each	15.85
641-4640-0101	DMI® Comfort Grip™ Cutlery, Fork	1 each	15.85
641-4640-0103	DMI® Comfort Grip™ Cutlery, Soup Spoon	1 each	15.85
641-4640-0100	DMI® Comfort Grip™ Cutlery, Knife	1 each	15.85
640-8188-0200	DMI® Universal Beverage Holder	1 each	13.39
	Reaching
640-1774-0623	DMI® Suction Cup Reacher, 33"	1 each	11.05
640-1768-0623	DMI® Folding Aluminum Reacher with Magnetic Tip, 32"	1 each	8.79
640-1764-0623	DMI® Aluminum Reacher with Magnetic Tip, 32"	1 each	9.80
640-1764-0621	DMI® Aluminum Reacher with Magnetic Tip, 26"	1 each	8.60
	Dressing
641-8173-0000	Dressing, reaching kit	1 each	25.05
Misc
640-5401-0000	DMI® Long Handle Call Bell	1 each	3.79